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Rheumatology (Oxford). 2014 Aug;53(8):1431-8. doi: 10.1093/rheumatology/keu011. Epub 2014 Mar 14.

Primary cardiac disease in systemic lupus erythematosus patients: protective and risk factors--data from a multi-ethnic Latin American cohort.

Author information

1
Reumatología, Hospital Interzonal General de Agudos General San Martín, La Plata, Argentina, Division of Clinical Immunology and Rheumatology, Department of Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA, Departamento de Estadística, Universidad Nacional de Rosario, Reumatología, Hospital Provincial de Rosario, Rosario, Reumatología, Hospital Privado, Centro Médico de Córdoba, Córdoba, Argentina, Departmento de Medicina, Escola Paulista de Medicina, Universidade Federal de São Paulo, Reumatología, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Reumatología, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil, Reumatología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile, Reumatología, Universidad CES, Reumatología, Universidad de Antioquia, Hospital Universitario, Fundación San Vicente, Medellin, Colombia, Reumatología, Centro de Investigaciones Médico Quirúrgicas, Habana, Cuba, Reumatología, Hospital de Especialidades Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico Distrito Federal, Reumatología, Centro Médico ABC, Ciudad de Mexico, Reumatología, Hospital Miguel Hidalgo, Aguascalientes, Mexico, Reumatología, Hospital Nacional Guillermo Almenara Irigoyen EsSalud, Lima, Peru and Reumatología, Hospital Universitario de Caracas, Venezuela.
2
Reumatología, Hospital Interzonal General de Agudos General San Martín, La Plata, Argentina, Division of Clinical Immunology and Rheumatology, Department of Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA, Departamento de Estadística, Universidad Nacional de Rosario, Reumatología, Hospital Provincial de Rosario, Rosario, Reumatología, Hospital Privado, Centro Médico de Córdoba, Córdoba, Argentina, Departmento de Medicina, Escola Paulista de Medicina, Universidade Federal de São Paulo, Reumatología, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Reumatología, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil, Reumatología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile, Reumatología, Universidad CES, Reumatología, Universidad de Antioquia, Hospital Universitario, Fundación San Vicente, Medellin, Colombia, Reumatología, Centro de Investigaciones Médico Quirúrgicas, Habana, Cuba, Reumatología, Hospital de Especialidades Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico Distrito Federal, Reumatología, Centro Médico ABC, Ciudad de Mexico, Reumatología, Hospital Miguel Hidalgo, Aguascalientes, Mexico, Reumatología, Hospital Nacional Guillermo Almenara Irigoyen EsSalud, Lima, Peru and Reumatología, Hospital Universitario de Caracas, Venezuela. baponsestel@buenaventuraguarani.com.ar.

Abstract

OBJECTIVES:

The aim of this study was to assess the cumulative incidence, risk and protective factors and impact on mortality of primary cardiac disease in SLE patients (disease duration ≤2 years) from a multi-ethnic, international, longitudinal inception cohort (34 centres, 9 Latin American countries).

METHODS:

Risk and protective factors of primary cardiac disease (pericarditis, myocarditis, endocarditis, arrhythmias and/or valvular abnormalities) were evaluated.

RESULTS:

Of 1437 patients, 202 (14.1%) developed one or more manifestations: 164 pericarditis, 35 valvulopathy, 23 arrhythmias, 7 myocarditis and 1 endocarditis at follow-up; 77 of these patients also had an episode of primary cardiac disease at or before recruitment. In the multivariable parsimonious model, African/Latin American ethnicity [odds ratio (OR) 1.80, 95% CI 1.13, 2.86], primary cardiac disease at or before recruitment (OR 6.56, 95% CI 4.56, 9.43) and first SLICC/ACR Damage Index for SLE assessment (OR 1.31, 95% CI 1.14, 1.50) were risk factors for the subsequent occurrence of primary cardiac disease. CNS involvement (OR 0.44, 95% CI 0.25, 0.75) and antimalarial treatment (OR 0.62, 95% CI 0.44, 0.89) at or before recruitment were negatively associated with the occurrence of primary cardiac disease risk. Primary cardiac disease was not independently associated with mortality.

CONCLUSION:

Primary cardiac disease occurred in 14.1% of SLE patients of the Grupo Latino Americano de Estudio de Lupus cohort and pericarditis was its most frequent manifestation. African origin and lupus damage were found to be risk factors, while CNS involvement at or before recruitment and antimalarial treatment were protective. Primary cardiac disease had no impact on mortality.

KEYWORDS:

antimalarials; cardiac disease; mortality; survival; systemic lupus erythematosus

PMID:
24633413
DOI:
10.1093/rheumatology/keu011
[Indexed for MEDLINE]

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